Flu sufferers will be sent to hospital in GP shake-up

Patients will be able to go to hospital for so-called "Monday morning" ailments such as colds, flu and headaches, normally treated in GPs' surgeries, under plans announced yesterday by the Government to expand primary care services in the NHS.

Hospitals and health authorities will be given permission to hire GPs on annual salaries of around pounds 50,000 to open up surgeries in areas where doctors are reluctant to run general practices. They could use clinics in the NHS hospitals, or empty shop premises in the high street.

Most GPs are independent contractors, with NHS contracts delivering about pounds 45,000 a year. With additional sums for practice staff and expenses, it can provide a comfortable living, but many family doctors are now complaining about the increasing workload, stress, and long hours, which may be putting off young doctors from joining general practices in the inner cities, where the problems of recruitment and retention are particularly acute. Hospitals and health authorities will be able to attract GPs by offering them more than the contract rate for the job. They will be able to offer women doctors the chance of more flexible working arrangements to enable them to return to the profession after a career break for having children.

The GPs will still act as "gatekeepers", deciding whether to refer their patients to the consultants in the hospital for more treatment.

Alan Milburn, the health minister, yesterday announced that salaried GPs would be encouraged, in a series of pilot schemes, to start from April, 1998. But he ruled out allowing supermarkets or high street chemists to run general practices by hiring GPs. Mr Milburn said it would help to recruit family doctors to areas such as Sunderland, Leeds, and London, where shortages were being experienced.

Other GPs will be allowed to develop "one stop" surgeries, combining care for chronic diseases, minor injuries, the mentally ill and may include community hospital beds for short-stay treatment. One practice in Newark wants to offer optician's services, dentistry, a pharmacy, a lay counsellor, and a rural advice centre.

"The Government's vision is to bring the NHS closer to home. Some of these proposals are about blurring the distinction between primary [GPs] and secondary [hospital] care," the minister said.